MEDICARE: MEDFORD ORTHOPAEDIC MEDICAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	G78679	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134318926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDFORD ORTHOPAEDIC MEDICAL CORP

Provider Business Mailing Address
First Line	:	PO BOX 6217
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91802-6217
Country	:	US
Telephone Number	:	626-247-2250
Fax Number	:	626-247-2259

Provider Business Practice Location Address
First Line	:	301 W HUNTINGTON DR STE 617
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-1518
Country	:	US
Telephone Number	:	626-247-2250
Fax Number	:	626-247-2259

Authorized Official
Title or Position	:	OFFICE ADMINISTRATOR
Name	:	MRS. ANHTHU HANG
Credential	:
Telephone Number	:	626-247-2250

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	11/10/2009

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Directions to “MEDFORD ORTHOPAEDIC MEDICAL CORP ” Practice Location

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